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Registrant #1

The information for this user will be changed as shown in the form below.

Date of Birth:Phone:Gender:

Who are you registering? *

MeAdult, 18+

Other AdultAdult, 18+

MinorUnder 18

By selecting this box, you are indicating that you are the parent/guardian of the person you are about to register. Additionally, if the child is under the age of 13, you are consenting to the collection and use of the information about the child for the purpose of the registration as described in our privacy policy.

Choose one of your existing profiles to quickly fill in the registration form.

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Basic Info

Parent/Guardian First Name *

Parent/Guardian Last Name *

First Name *

Last Name *

E-mail Address *

Confirm E-mail *

Password *

To be able to access / edit your registration.

Confirm Password *

Additional Information

Date of Birth *

Format: mm/dd/yyyy

Used for age group calculations

Gender *MaleFemale

Phone *

Format: ###-###-####

Address

Street Address *

Country *

Zip Code *

City *

State *

Choose Your Event *

Run/walk to support families fighting children's cancer

Splash For A Cure 5K Virtual Adult Registration

$50.00 + $3.00 SignUp Fee ?

(Group Pricing)

Registration includes:

T-shirt mailed directly to your door *Must register by August 1st to be guaranteed a shirt *

Free shipping

Your purchase is a donation to support families in Virginia fighting children's cancer

Get the kids moving too

Splash For A Cure 5K Virtual Youth Registration

$25.00 + $2.50 SignUp Fee ?

(Group Pricing)

Registration includes:

T-shirt mailed directly to your door *Must register before August 1st to be guaranteed a shirt*

Free Shipping

Your purchase is a donation to support families in Virginia fighting Children's cancer

Waiver

In consideration of you accepting this entry, I, the participant, intending to be legally bound do hereby waive and forever release any and all right and claims for damages or injuries that I may have against the Event Director, RunSignup.com, and all of their agents assisting with the event, sponsors and their representatives, volunteers and employees for any and all injuries to me or my personal property. This release includes all injuries and/or damages suffered by me before, during or after the event. I recognize, intend and understand that this release is binding on my heirs, executors, administrators, or assignees.

I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able to do so and properly trained. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, the effects of weather, traffic, and course conditions, and waive any and all claims which I might have based on any of those and other risks typical found in running a road race. I acknowledge all such risks are known and understood by me. I agree to abide by all decisions of any race official relative to my ability to safely complete the run. I certify as a material condition to my being permitted to enter this race that I am physically fit and sufficiently trained for the completion of this event and that a licensed Medical Doctor has verified my physical condition.

In the event of an illness, injury or medical emergency arising during the event I hereby authorize and give my consent to the Event Director to secure from any accredited hospital, clinic and/ or physician any treatment deemed necessary for my immediate care. I agree that I will be fully responsible for payment of any and all medical services and treatment rendered to me including but not limited to medical transport, medications, treatment and hospitalization.

By submitting this entry, I acknowledge (or a parent or adult guardian for all children under 18 years) having read and agreed to the above release and waiver.

Further, I grant permission to all the foregoing to use my name, voice and images of myself in any photographs, motion pictures, results, publications or any other print, videographic or electronic recording of this event for legitimate purposes.

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By checking this box, I agree to the waiver and that I am 18 or older, or that I have the authority to register these participants and agree to the waiver for them, and agree to the Privacy Policy.

This is a service fee for processing your race application.

You have selected to edit the information for .
By doing so, information for other races or events you have registered for may be updated as well.
You should only use this option to update information about , such as a typo in their name or an address change.
If you are trying to register someone else like a spouse, child, or friend, you should NOT use this option.

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